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Profile Details

Name (required)

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Person Completing this Survey (required)

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Contact Phone Number (required)

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Email (required)

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Business Represented (required)

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Business Physical Address (required)

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Business Mailing Address (required)

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Business Phone (required)

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Business Email (required)

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Website URL

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Primary Product/Service of Business (required)

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Secondary Product/Service of Business

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1. Is your business a
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2. How many people do you employ?

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3. What is the range of your annual sales?
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4. What are your primary market areas?

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5. How do you market your product/service?

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6. Do you have a website for your business?

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7. Do you have a Facebook page for your business?

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8. Please list your primary customers:

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9. Please list your primary suppliers:

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10. Please list any customers you would like to serve:

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11. Please list any suppliers you would like to use and products you are interested in purchasing:

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12. What would you like to gain from your participation in the Naturally Meramec Consortium? (required)

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13. What are the specific needs of your business? (required)

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